CLINICAL REVIEW Mark K. Wax, Section Editor MULTIDISCIPLINARY MANAGEMENT OF HEAD AND NECK SARCOMAS R. James Colville, MSc, FRCS (Plast), 1 Fraser Charlton, PhD, FRCPath, 2 Charles G. Kelly, FRCP, FRCR, 3 Jonathan J. Nicoll, FRCP, FRCR, 4 Neil R. McLean, MD, FRCS 5 1 Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom. E-mail: jcolville@cmki.org 2 Department of Histopathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom 3 Northern Centre for Cancer Treatment, Newcastle General Hospital, NE4 6BE, United Kingdom 4 Department of Oncology, Cumberland Infirmary, Carlisle CA2 7HY, United Kingdom 5 Wansbeck General Hospital, Woodhorn Lane, Ashington, Northumberland NE63 9JJ, United Kingdom Accepted 8 March 2005 Published online 5 August 2005 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.20232 Abstract: Background. Head and neck sarcomas are ex- tremely rare. This article reviews the management and outcomes in a multidisciplinary clinic. Methods. The records of 41 male and 19 female patients (mean age, 50 years) were reviewed. Forty percent underwent surgical resection only, 35% underwent surgery and adjuvant therapy, and 25% underwent radiotherapy and/or chemother- apy without surgery. Seventy-one percent had complete histo- logic clearance. Results. The mean follow-up was 3 years and 10 months, with an overall 5-year survival rate of 60%. Completeness of surgical excision was highly significant in determining 5-year local control (p < .025), and the addition of adjuvant radio- therapy had a major effect on local control, but only if complete surgical clearance had been achieved (p < .025). As expected, patients with more aggressive tumors had a significantly poorer overall prognosis, and achieving local control led to an enhanced 5-year survival (p < .025). Conclusion. These tumors are best managed in multidisci- plinary clinics, and the mainstay of treatment is wide local excision and planned postoperative adjuvant radiotherapy. A 2005 Wiley Periodicals, Inc. Head Neck 27: 814 – 824, 2005 Keywords: head and neck; sarcoma; multidisciplinary; radio- therapy; surgery Sarcomas are rare malignant tumors of mesen- chymal origin that include soft tissue and bony tumors and account for less than 1% of all tumors of the head and neck region. 1 The histology of sarcomas is extremely complex and requires immunochemical analysis to distinguish between the different subtypes. 2 Grading is based on the Trojani classification, 3 and there is considerable biologic variation in the aggressiveness of differ- ent sarcomas; low-grade tumors tend to recur locally, whereas high-grade lesions also metasta- Correspondence to: R. J. I. Colville Presented at the winter meeting of the British Association of Plastic Surgeons, London, November 2002, and Royal Australian College of Surgeons Annual Scientific Congress 2003. B 2005 Wiley Periodicals, Inc. HEAD & NECK September 2005 814 Head and Neck Sarcomas